Nursing Elites

1. A client with a diagnosis of rheumatoid arthritis is prescribed methotrexate. What is the primary action of this medication?

• A. Increases joint lubrication
• B. Reduces inflammation by suppressing the immune system
• C. Enhances bone density
• D. Stimulates cartilage regeneration

Correct answer: B

Rationale: The correct answer is B: Methotrexate is an immunosuppressant that works by suppressing the immune system, thereby reducing inflammation in rheumatoid arthritis. Methotrexate does not directly increase joint lubrication (Choice A) as its primary action is on the immune system. Choices C and D are incorrect since methotrexate does not enhance bone density or stimulate cartilage regeneration. It is crucial for healthcare providers to understand the mechanism of action of medications to provide safe and effective care to patients.

2. The nurse is assessing a client who has been receiving total parenteral nutrition (TPN) for several days. Which complication should the nurse monitor for?

• A. Hyperglycemia
• B. Hypoglycemia
• C. Hyponatremia
• D. Hypokalemia

Correct answer: B

Rationale: The correct answer is B: Hypoglycemia. When a client is receiving total parenteral nutrition (TPN) with a high glucose content, the risk of hypoglycemia is significant due to sudden increases in insulin release in response to the glucose load. The nurse should monitor for signs and symptoms of hypoglycemia such as shakiness, sweating, palpitations, and confusion. Hyperglycemia (choice A) is not typically a complication of TPN as the high glucose content is more likely to cause hypoglycemia. Hyponatremia (choice C) and hypokalemia (choice D) are electrolyte imbalances that can occur in clients receiving TPN, but hypoglycemia is the more common and immediate concern that the nurse should monitor for.

3. A client begins taking an antidepressant drug during the second day of hospitalization. Which assessment is most important for the nurse to include in this client's plan of care while the client is taking the antidepressant?

• A. Appetite
• B. Mood
• C. Withdrawal
• D. Energy level

Correct answer: B

Rationale: Corrected Rationale: Monitoring the client's mood is essential when starting an antidepressant to assess for any changes or adverse effects related to the medication. Changes in mood can indicate the effectiveness of the antidepressant or potential side effects. Assessing appetite (Choice A) is important but not as crucial as monitoring mood in this context. Withdrawal symptoms (Choice C) are more relevant when discontinuing antidepressants rather than starting them. Energy level (Choice D) can be influenced by various factors and may not directly reflect the client's response to the antidepressant.

4. A healthcare provider is conducting a health education session about the prevention of type 2 diabetes. What lifestyle modification should be emphasized?

• A. Increasing physical activity
• B. Reducing dietary sugar intake
• C. Regular health screenings
• D. All of the above

Correct answer: D

Rationale: To effectively prevent type 2 diabetes, individuals should focus on a combination of lifestyle modifications. Increasing physical activity helps maintain a healthy weight and improves insulin sensitivity. Reducing dietary sugar intake can lower the risk of developing diabetes by managing blood sugar levels. Regular health screenings are crucial for early detection and timely intervention. Emphasizing all these modifications together provides a comprehensive approach to diabetes prevention. Choices A, B, and C are all important components of a healthy lifestyle that can contribute to reducing the risk of type 2 diabetes.

5. The healthcare provider is preparing to administer a 1.2mL injection to a 4-year-old. Which is the best site to administer an IM injection?

• A. Vastus Lateralis
• B. Radial artery
• C. Dorsogluteal
• D. Rectus femoris

Correct answer: A

Rationale: The correct answer is A, Vastus Lateralis. The vastus lateralis site is recommended for IM injections in small children due to its large muscle mass, making it suitable for injections in pediatric patients. Choices B, C, and D are incorrect. The radial artery is not a site for IM injections; it is a site for arterial puncture. The dorsogluteal site is not recommended for children due to potential risks, such as injury to the sciatic nerve. The rectus femoris is not typically used for IM injections in children, as other sites like the vastus lateralis are more commonly preferred.

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